Evaluation of a six-week professional education curriculum designed to retain registered psychiatric nurses

During the past few years there has been a drastic shortage of registered nurses in the field. The shortage appears to have affected the field of psychiatric mental health nursing most intensely. The psychiatric nursing shortage is a multifaceted problem grounded in decreasing federal funds for advanced clinical training, inadequate undergraduate psychiatric experiences, lack of a well prepared articulate role model, the integrated curriculum and the confusion and blurring associated with the roles and functions of the psychiatric mental health nurse.^ This dissertation will describe the current nursing shortage; the decline in enrollment to nursing programs; the history of psychiatric nursing as a discipline; the shortage of psychiatric mental health nurses; factors contributing to the psychiatric nursing shortage and a plan for a solution to the nursing shortage in psychiatry.^ The paper focuses on an evaluation conducted on an internship curriculum designed to facilitate effective nursing care in the treatment of clients who exhibit emotional problems. The purpose of this study was to attract and retain nurses to employment opportunities in four Hospital Corporation of America (HCA) facilities, using a six week internship program.^ The study will yield an analysis of the effect of combining psychodynamic principles and knowledge with skills in the clinical area. The demands of educational practice have been merged with the discipline of psychiatric nursing in the development of this curriculum. ^

Equity policy, educational practice, and limited English proficient (LEP) students in two high schools in Miami

Most studies of language minority students' performance focus on students' characteristics. This study uses qualitative methodology to examine instead how educational policies and practices affect the tracking of language minority students who are classified as limited English proficient (LEP). The placement of LEP students in core courses (English, Math, Social Studies, and Science) is seen as resulting from the interaction between school context and student characteristics. The school context includes factors such as equity policy requirements, overcrowding, attitudes regarding immigrants' academic potential, tracking, and testing practices. Interaction among these factors frequently leads to placement in lower track courses. It was found that the absence of formal tracks could be misleading to immigrant students, particularly those with high aspirations who do not understand the implications of the informal tracking system. Findings are discussed in relation to current theoretical explanations for minority student performance. ^

Integrated assessment of water conservation practices for sustainable management strategies

Miami-Dade County implemented a series of water conservation programs, which included rebate/exchange incentives to encourage the use of high efficiency aerators (AR), showerheads (SH), toilets (HET) and clothes washers (HEW), to respond to the environmental sustainability issue in urban areas. This study first used panel data analysis of water consumption to evaluate the performance and actual water savings of individual programs. Integrated water demand model has also been developed for incorporating property’s physical characteristics into the water consumption profiles. Life cycle assessment (with emphasis on end-use stage in water system) of water intense appliances was conducted to determine the environmental impacts brought by each practice. Approximately 6 to 10 % of water has been saved in the first and second year of implementation of high efficiency appliances, and with continuing savings in the third and fourth years. Water savings (gallons per household per day) for water efficiency appliances were observed at 28 (11.1%) for SH, 34.7 (13.3%) for HET, and 39.7 (14.5%) for HEW. Furthermore, the estimated contributions of high efficiency appliances for reducing water demand in the integrated water demand model were between 5 and 19% (highest in the AR program). Results indicated that adoption of more than one type of water efficiency appliance could significantly reduce residential water demand. For the sustainable water management strategies, the appropriate water conservation rate was projected to be 1 to 2 million gallons per day (MGD) through 2030. With 2 MGD of water savings, the estimated per capita water use (GPCD) could be reduced from approximately 140 to 122 GPCD. Additional efforts are needed to reduce the water demand to US EPA’s “Water Sense” conservation levels of 70 GPCD by 2030. Life cycle assessment results showed that environmental impacts (water and energy demands and greenhouse gas emissions) from end-use and demand phases are most significant within the water system, particularly due to water heating (73% for clothes washer and 93% for showerhead). Estimations of optimal lifespan for appliances (8 to 21 years) implied that earlier replacement with efficiency models is encouraged in order to minimize the environmental impacts brought by current practice.

Equity policy, educational practice, and limited english proficient (LEP) students in two high schools in Miami

Most studies of language minority students' performance focus on students' characteristics. This study uses qualitative methodology to examine instead how educational policies and practices affect the tracking of language minority students who are classified as limited English proficient (LEP). The placement of LEP students in core courses (English, Math, Social Studies, and Science) is seen as resulting from the interaction between school context and student characteristics. The school context includes factors such as equity policy requirements, overcrowding, attitudes regarding immigrants' academic potential, tracking, and testing practices. Interaction among these factors frequently leads to placement in lower track courses. It was found that the absence of formal tracks could be misleading to immigrant students, particularly those with high aspirations who do not understand the implications of the informal tracking system. Findings are discussed in relation to current theoretical explanations for minority student performance.

Reformed county government structure and service delivery performance: An integrated study of Florida counties

The most fundamental and challenging function of government is the effective and efficient delivery of services to local taxpayers and businesses. Counties, once known as the “dark continent” of American government, have recently become a major player in the provision of services. Population growth and suburbanization have increased service demands while the counties' role as service provider to incorporated residents has also expanded due to additional federal and state mandates. County governments are under unprecedented pressure and scrutiny to meet citizens' and elected officials' demands for high quality, and equitable delivery of services at the lowest possible cost while contending with anti-tax sentiments, greatly decreased state and federal support, and exceptionally costly and complex health and public safety problems. ^ This study tested the reform government theory proposition that reformed structures of county government positively correlate with efficient service delivery. A county government reformed index was developed for this dissertation comprised of form of government, home-rule status, method of election, number of government jurisdictions, and number of elected officials. The county government reform index and a measure of relative structural fragmentation were used to assess their impact on two measures of service output: mean county road pavement condition and county road maintenance expenditures. The study's multi-level design triangulated results from different data sources and methods of analysis. Data were collected from semi-structured interviews of county officials, secondary archival sources, and a survey of 544 elected and appointed officials from Florida's 67 counties. The results of the three sources of data converged in finding that reformed Florida counties are more likely than unreformed counties to provide better road service and to spend less on road expenditures. The same results were found for unfragmented Florida counties. Because both the county government reform index and the fragmentation variables were specified acknowledging the reform theory as well as elements from the public-choice model, the results help explain contradicting findings in the urban service research. ^ Therefore, as suggested by the corroborated findings of this dissertation, reformed as well as unfragmented counties are better providers of road maintenance service and do so in a less costly manner. These findings hold although the variables were specified to capture theoretical arguments from the consolidated as well as the public-choice theories suggesting a way to advance the debate from the consolidated-fragmented dichotomy of urban governance. ^

Globalization and the Marginalization of Educational Purpose: Preparation of Workers and Citizens for the 21st Century and the Vision of Sustainable Futures

Human capital development remains a primary goal of modern schooling. This paper raises questions concerning the link between global economic needs and school-based human capital development. The primary mission of preparing students for the workplace may weaken other educational missions vital in achieving a more sustainable future for humanity.

Medical Curriculum at Selected Colleges: Foundations and Integrated Presentation of Basic Medical Sciences Distribution over Pre-Clerkship Period

Overview and statistics on the medical curriculum at Arizona, Emory, FIU, Rochester, and Vermont.

The Use of Foucault in the Creation of Educational History: A Review of Literature

This research creates a literature review. It investigates the viability of a using Foucauldian critical analysis in creating an educational history. It examines historical methods in education and Foucauldian theory looking for commonalities and offers suggestions on the usage of Foucault in creating history in education.

The Integrated Process of Engagement in Adult Learning

This paper explores the role of engagement in adult learning based on Illeris’ three dimensional model of learning and Yang’s holistic theory of knowledge and learning. Engagement and learning are integrated processes by which adult learners gain a deeper understanding and make meaning of the activities he or she is exposed to in a given learning environment.

Efficacy of educational interventions to reduce homophobia on the *college campus

Homophobic attitudes, irrational fears and negative attitudes against gay men and lesbians exist on the college campus (Lance, 2002; Rankin, 2003). Educators wishing to change these attitudes need to know what types of intervention would be effective. This investigation empirically assessed the degree of homophobia in a group of college students, and changes in the degree of homophobia following two levels of educational intervention that were rooted in educational theories and social contact theory. A 25-item scale developed by Hudson and Ricketts to measure the degree of negative attitudes toward gay men and lesbians was used in English classes at a southeastern university. This study examined the relationship between different demographic groups and the degree of change obtained as a result of the interventions. ^ Findings did not suggest that either interaction with gay men and lesbians in the form of a speaker panel or viewing a “coming out” episode of the Ellen show reduced homophobia to a significant extent. Results did demonstrate the Caribbeans and right wing authoritarians tend to be more homophobic. Post hoc analysis investigated factors that may have contaminated the interventions. Speaker Identification was a significant predictor of change in degree of homophobia. ^

The effects of advanced practice nurses (APNs) as intensivists in a surgical intensive care unit (SICU) on patient outcomes, healthcare charges, and apn intensivist services in the SICU

Intensive Care Units (ICUs) account for over 10 percent of all US hospital beds, have over 4.4 million patient admissions yearly, approximately 360,000 deaths, and account for close to 30% of acute care hospital costs. The need for critical care services has increased due to an aging population and medical advances that extend life. The result is efforts to improve patient outcomes, optimize financial performance, and implement models of ICU care that enhance quality of care and reduce health care costs. This retrospective chart review study examined the dose effect of APN Intensivists in a surgical intensive care unit (SICU) on differences in patient outcomes, healthcare charges, SICU length of stay, charges for APN intensivist services, and frequency of APNs special initiatives when the SICU was staffed by differing levels of APN Intensivist staffing over four time periods (T1-T4) between 2009 and 2011. The sample consisted of 816 randomly selected (204 per T1-T4) patient chart data. Study findings indicated reported ventilator associated pneumonia (VAP) rates, ventilator days, catheter days and catheter associated urinary tract infection (CAUTI) rates increased at T4 (when there was the lowest number of APN Intensivists), and there was increased pressure ulcer incidence in first two quarters of T4. There was no statistically significant difference in post-surgical glycemic control (M = 142.84, SD = 40.00), t (223) = 1.40, p = .17, and no statistically significant difference in the SICU length of stay among the time-periods (M = 3.27, SD = 3.32), t (202) = 1.02, p = .31. Charges for APN services increased over the 4 time periods from $11,268 at T1 to $51,727 at T4 when a system to capture APN billing was put into place. The number of new APN initiatives declined in T4 as the number of APN Intensivists declined. Study results suggest a dose effect of APN Intensivists on important patient health outcomes and on the number of APNs initiatives to prevent health complications in the SICU. ^

Efficacy of Educational Interventions to Reduce Homophobia on the College Campus

Homophobic attitudes, irrational fears and negative attitudes against gay men and lesbians exist on the college campus (Lance, 2002; Rankin, 2003). Educators wishing to change these attitudes need to know what types of intervention would be effective. This investigation empirically assessed the degree of homophobia in a group of college students, and changes in the degree of homophobia following two levels of educational intervention that were rooted in educational theories and social contact theory. A 25-item scale developed by Hudson and Ricketts to measure the degree of negative attitudes toward gay men and lesbians was used in English classes at a southeastern university. This study examined the relationship between different demographic groups and the degree of change obtained as a result of the interventions. Findings did not suggest that either interaction with gay men and lesbians in the form of a speaker panel or viewing a “coming out” episode of the Ellen show reduced homophobia to a significant extent. Results did demonstrate the Caribbeans and right wing authoritarians tend to be more homophobic. Post hoc analysis investigated factors that may have contaminated the interventions. Speaker Identification was a significant predictor of change in degree of homophobia.

The Effects of Advanced Practice Nurses (APNs) as Intensivists in a Surgical Intensive Care Unit (SICU) on Patient Outcomes, Healthcare Charges, and APN Intensivist Services in the SICU

Intensive Care Units (ICUs) account for over 10 percent of all US hospital beds, have over 4.4 million patient admissions yearly, approximately 360,000 deaths, and account for close to 30% of acute care hospital costs. The need for critical care services has increased due to an aging population and medical advances that extend life. The result is efforts to improve patient outcomes, optimize financial performance, and implement models of ICU care that enhance quality of care and reduce health care costs. This retrospective chart review study examined the dose effect of APN Intensivists in a surgical intensive care unit (SICU) on differences in patient outcomes, healthcare charges, SICU length of stay, charges for APN intensivist services, and frequency of APNs special initiatives when the SICU was staffed by differing levels of APN Intensivist staffing over four time periods (T1-T4) between 2009 and 2011. The sample consisted of 816 randomly selected (204 per T1-T4) patient chart data. Study findings indicated reported ventilator associated pneumonia (VAP) rates, ventilator days, catheter days and catheter associated urinary tract infection (CAUTI) rates increased at T4 (when there was the lowest number of APN Intensivists), and there was increased pressure ulcer incidence in first two quarters of T4. There was no statistically significant difference in post-surgical glycemic control (M = 142.84, SD= 40.00), t (223) = 1.40, p = .17, and no statistically significant difference in the SICU length of stay among the time-periods (M= 3.27, SD = 3.32), t (202) = 1.02, p= .31. Charges for APN services increased over the 4 time periods from $11,268 at T1 to $51,727 at T4 when a system to capture APN billing was put into place. The number of new APN initiatives declined in T4 as the number of APN Intensivists declined. Study results suggest a dose effect of APN Intensivists on important patient health outcomes and on the number of APNs initiatives to prevent health complications in the SICU.